Tips on how NOT to appear like a Drug seeker

Specialties Emergency

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ERNP

189 Posts

Specializes in ER, critical care.

I do find it a bit perplexing as to why anyone would try and scam drugs from an ED.

Far easier to just pick up a phone and call up a dealer rather than hang around in the ED making up stories and hoping that you will be lucky enough to get what you need.

Sometimes people truly have untreated or undertreated pain.

Sometimes people are trying to get the meds for someone else.

Sometimes people are addicted and need the meds to avoid the sickness of withdrawal.

Sometimes people just want to get stoned.

And sometimes, the people haunting the ER ARE the ones selling drugs.

Oh and last but not least, the dealer doesn't take medicaid.

WillowBrook

32 Posts

Sometimes people truly have untreated or undertreated pain.

Sometimes people are trying to get the meds for someone else.

Sometimes people are addicted and need the meds to avoid the sickness of withdrawal.

Sometimes people just want to get stoned.

And sometimes, the people haunting the ER ARE the ones selling drugs.

Oh and last but not least, the dealer doesn't take medicaid.

Yeah I know the reasons that people might got to an ER to seek drugs, but I guess even as a former user it's not a practice I can really understand...more so with the one's that do it all the time. I mean where I come from (Adelaide, South Australia) if you are a heroin addict you pretty much know where to get heroin at all times, if you can't afford a hit there are ways to make quick money (prostitution for example) and you can always go from friend to friend begging for a small taste (much more success generally than going to the ER), if there is a time when there is a Heroin drought and nobody can score then you tend to know what Doctors you can go to who will get you onto Methadone within 24 hours or will help you out with a shot of morphine every now and then to get you through. It just seems so unneccessary to go to an ED and wait for hours without any guarantee you will get what you want, I think you'd have to be absolutely desperate to do that. Then again I suppose some people are just that desperate.

Question for people out of interest....would you have slightly more respect for a drug seeker if they just came out and honestly said that they were in withdrawal and needed something to help them out?

WillowBrook

32 Posts

HA HA HA HA! You are describing so many of my pain management patients. I see this crap all the time, they'll even come in with a police report stating someone robbed them and took that meds! I just write them a script for a clonidine taper and tell them this will keep them out of withdrawal until they can get another refill. I just discharged someone today because I suspected she was abusing her meds...turned out I was right on the money...she tested positive for benzo's and oxycodone, but she was only being prescribed methadone. When she told me that she was getting the other meds from another doc, I showed her the contract she signed stating that WE were the only ones allowed to prescribe a controlled substance!!! She has 45 days to find another physician. I LOVE busting the losers!

I understand it must be very frustrating to have to deal with people constantly trying to scam the system, but please try and remember these "losers" as you call them are somebody's son, daughter, friend or loved one and they have a problem which needs help and understanding not judgement.

LuvMyGamecocks

184 Posts

Specializes in Cardiac, Acute/Subacute Rehab.
Question for people out of interest....would you have slightly more respect for a drug seeker if they just came out and honestly said that they were in withdrawal and needed something to help them out?

Wouldn't that be called ENABLING????

I'm still a student, so you're welcome to take this as an unexperienced opinion.

Absolutely not. It seems to me that there are FAR more important things that ED staff can focus their attention on, rather than cuddling an addict. I realize addiction is a disease, and that some people just aren't equipped with the tools necessary to either NEVER have started taking drugs or to quit once they have started. But, I don't feel like there should be any obligation by the ED staff to treat addiction withdrawal.

Don't addicts, upon entry to detox, have to actually deal with all the withdrawal symptoms before the actual road to recovery can begin? I know there are serious repercussions of alcoholism withdrawal.....

WillowBrook

32 Posts

LuvmyGamecocks - I was just wondering how much of a difference in attitudes would honesty as opposed to trying to scam produce, but I do agree with what you said. I may not have chosen to be an addict but then again neither did anyone hold me down and force a needle in my arm. My problem, my responsibility to deal with and that responsibility doesn't include wasting an ER's time and resources.

And yes you're right that the physical withdrawal for a Heroin addict is only the first part of "getting clean". The physical side (although it is very painful) is actually the easy part, it's the psychological addiction that is harder to overcome. It is easy to get clean but it's certainly not easy to stay clean.

leelinn

8 Posts

Why are people so worried about giving someone pain medication? I thought that was what it was made for. They need to get over the idea that everyone is looking for a high and do their job and help people. Get off of their soap boxes and stop judging everyone. Even drug abusers have pain and sometimes severe pain and they need to be medicated like any other human being. Let god be the judge. I am sorry that you had to suffer like that. They need their licence taken. What horrible medical people.

EDValerieRN, ASN, RN

1 Article; 178 Posts

Specializes in ER, Peds, Charge RN.

First off, yes. If you are a drug seeker, and you want medication, just be honest. Don't fake chest pain and make me do a full cardiac workup when really you only wanted to get high. If it were my personal choice, I would not give you the medication... however, it depends on the MD working. One is known as the "candy man" and gives anyone whatever they want. Most of them use common sense.

LeeLin: drug seeking is a real problem. Sure, addicts have real pain. Sure, pain meds were meant for people in pain. That doesn't mean that we should turn a blind eye and assume that everyone asking for dilaudid "slam it in" is really in pain. Not all people are. Some of them want a fix. There is no "soap box" about it... it's just a fact. And as a prudent nurse, you should be aware of how many rx's you have given a patient this week for a narc. Have one overdose on the prescriptions you gave him, and you'll see there is a valid reason we worry about it.

This is coming for a nurse who will give the benefit of the doubt 99% of the time, and advocate for pain meds. I am not, however, stupid... and I will remember those patients who take me for it.

Specializes in Emergency Room.
Why are people so worried about giving someone pain medication? I thought that was what it was made for. They need to get over the idea that everyone is looking for a high and do their job and help people. Get off of their soap boxes and stop judging everyone. Even drug abusers have pain and sometimes severe pain and they need to be medicated like any other human being. Let god be the judge. I am sorry that you had to suffer like that. They need their licence taken. What horrible medical people.

I'm going to take a wild guess that you don't work in the ER/any area of first response. Drug seeking is a big problem in many EDs, and it takes up quite a bit of time and resources. How would you feel if you were in my ER having chest pain that was actually a cardiac event. But I'm in the next room over doing a full cardiac workup on the drug seeker who SAYS he has chest pain, but really just wants some dilaudid/demerol. So yes, people who are really having pain should be medicated, but we can't just go around pushing dilaudid on everyone who says he/she has TOE pain (and yes, I have had people with toe pain asking for heavy duty narcs).

You say we should get off our soapboxes....it sounds like you're on yours and having a great time judging the rest of us.

TazziRN, RN

6,487 Posts

Why are people so worried about giving someone pain medication? I thought that was what it was made for. They need to get over the idea that everyone is looking for a high and do their job and help people. Get off of their soap boxes and stop judging everyone. Even drug abusers have pain and sometimes severe pain and they need to be medicated like any other human being. Let god be the judge. I am sorry that you had to suffer like that. They need their licence taken. What horrible medical people.

Really? Did you know that if physicians knowingly contribute to an addict's needs by giving more narcotics, that he can be censured? This is why it's such a fine line, trying to determine who is truly in pain and who is just looking for a high. Do I have sympathy for the addict who just needs a fix? Yes. Will I "help" him by giving him a shot of demerol or morphine? Not without an argument.

country mom

379 Posts

II do find it a bit perplexing as to why anyone would try and scam drugs from an ED. I know people do it, but it just seems to be to be an awful lot of trouble and messing around for possibly no gain.

In my experience, I think that sometimes when people get their drugs from the ER or physician's office as opposed to a "dealer", they feel that it somehow legitimizes their drug use. It's almost like it's where "respectable" people go to get their fix. So many people are seeking a chemical solution to a deep, spiritual hurt that they have and often manifests as physical pain. Those are the people who walk out the door and I feel like I haven't done a thing for them.

Specializes in Case Manager, Home Health.
I truly am very sorry for patients that have not received adequate pain meds.

Amen. I'd rather a drug seeker get meds than a pt who is in real pain not get meds. Get my point? Which is worse? Please say the latter...

This whole issue really is a sad commentary on our (USA, in my case) "War On Drugs" society. Who's right is it to deny a truly in need pt pain meds because there are those who should not receive them?

One of my clinical rotations in the ER a pt was returning for a check of his sutured finger. Nothing major, right? It was a follow up in a small rural hospital. As I did his assessment I asked "On a scale of 1 to..." I didn't even finish and pt said "10!". I finished "...to 10 how would you rate your pain?" He again said "10!" BP, temp, pulse, etc all a-okay. There's no way this guy was telling the truth--period. I documented his reply "10/10" as well as mentioned this to the RN supervisor. pt left with Rx for 10 of something (I forget what it was)...

Point is, I'd rather see this guy get his meds than someone leave in pain any day, any time. If someone wants to fight the war on drugs, please don't deny pts pain meds. Sign up for the DEA.

Regards,

Ken

P.S. I landed a preceptorship in an ED so I'm sure I'll get to see much more of the "is he or she faking or not" question.

TazziRN, RN

6,487 Posts

One of my clinical rotations in the ER a pt was returning for a check of his sutured finger. Nothing major, right? It was a follow up in a small rural hospital. As I did his assessment I asked "On a scale of 1 to..." I didn't even finish and pt said "10!". I finished "...to 10 how would you rate your pain?" He again said "10!" BP, temp, pulse, etc all a-okay. There's no way this guy was telling the truth--period. I documented his reply "10/10" as well as mentioned this to the RN supervisor. pt left with Rx for 10 of something (I forget what it was)...

And that is a good way to handle it.....give the pt a script for enough to get by but not enough to do anything else with.

And congrats on your preceptorship!!

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